Monday, March 27, 2006

Tobacco Control Movement Credibility Starting to Decline as Public Can't Differentiate Legitimate from Far-Fetched Claims

In what I think will be a harbinger of things to come, the first signs of erosion of the credibility of the tobacco control movement are starting to occur.

It takes the form of an apparent inability on the part of the public to differentiate between legitimate scientific claims of the tobacco control movement and those that are quite far-fetched. The first signs of this inability to differentiate the soundness of the claims is evidenced by an op-ed column in which the far-fetched Helena and Pueblo claims are being lumped together with claims related to the hazardous effects of secondhand smoke.

In an op-ed column published in Sunday's The Daily Camera (Boulder, Colorado), Jay Ambrose argues against the need for Colorado's recently enacted statewide smoking ban by questioning the evidence linking secondhand smoke to disease. In doing so, he lumps together claims by tobacco control advocates that secondhand smoke is harmful with claims that smoking bans in Helena and Pueblo resulted in as much as a 40% immediate decline in heart attacks.

Because the Helena and Pueblo claims have been "debunked," Ambrose argues, therefore the secondhand smoke health claims also must be invalid.

According to Ambrose: "The Helena study has been pretty thoroughly debunked by now. Its sample was tiny, the research effort was anorexic and the study didn't account for a similar decrease in a year prior to the ban. On the face of it, quick and substantial declines in heart attacks after a ban such as the one in Pueblo are much less likely to have a connection with the ban than to be a reflection of normal statistical ups and downs. This probability is brought home by a study of the heart-attack drops after smoking bans in states with a combined population of tens of millions, not in one community of tens of thousands. The finding? There was no overall drop."

The Rest of the Story

To be sure, the Helena and Pueblo studies have little to do with the health effects of secondhand smoke or the justification for smoking bans. Showing that smoking bans result in a decline in heart attacks is not a necessary criterion in order to adopt such policies. And demonstrating that these bans result in a decline in heart attacks is not necessary to conclude that secondhand smoke is a health hazard.

In short, the Helena and Pueblo studies really have little to do with the relevant issue: the alleged health hazards of secondhand smoke.

So why are these studies, which are not directly related to the health effects of secondhand smoke, being used to discredit the literature on the health effects of secondhand smoke?

The reason is that these studies call into question the credibility of the tobacco control movement and its scientific claims: the legitimate ones and the unreasonable ones equally.

The Helena and Pueblo claims are being viewed simply as claims of the anti-smoking movement, no different from any other scientific claims being made by the movement, including those related to the health effects of secondhand smoke. If the Helena and Pueblo claims are invalid, and have been debunked, then what reason is there for the public to believe the other claims being made by the same movement, even if those claims may happen to be substantially more solid scientifically?

Perhaps the most telling aspect of this story is that it puts someone like me in an awkward position in terms of trying to refute its central argument. Specifically, I am in the uncomfortable predicament of having to argue that although Ambrose is 100% accurate in his depiction of the validity of the Helena and Pueblo claims, he is not accurate in his depiction of the secondhand smoke health hazard claims.

This "subtlety" (which I'm sure it is to the public) is, I think, too fine to be generally appreciated by the media and the public. How am I to convince them that the tobacco control movement is completely stretching the science when it comes to Helena and Pueblo, but that when it comes to the dangers of secondhand smoke - well - here they are being sound in their scientific claims.

And my position becomes even more awkward when one considers the fallacious claims being made by a number of anti-smoking groups about secondhand smoke itself: I have to argue that although the anti-smoking movement is completely making up scientific claims about the health effects of secondhand smoke, they are actually correct about the health hazards of tobacco smoke exposure - just not these particular claims.

To a public and a media that are not scientists and that do not necessarily have the ability to discern legitimate from invalid claims, this is a difficult argument to make, and even more difficult to expect them to swallow!

This is precisely what I was trying to suggest when I wrote on March 13 (about shoddy scientific claims being made by anti-smoking groups) that:

"these actions are going to harm the credibility of the anti-smoking movement simply because they are so completely implausible and seemingly taken out of nowhere. The extrapolations being made are so extreme that they threaten to undermine the public's perception of the anti-smoking movement's ability to interpret and report the results of scientific studies at all, even when that reporting is appropriate.The problem is - the public and policy makers will not necessarily know the difference. They will not be able to differentiate easily between when the claims we are making are legitimate and when they are extreme and errant extrapolations. They will just begin to question everything that we say."

And that is exactly what appears to be happening here.

While I acknowledge that this is just a small example - a single column in a small paper - I think it demonstrates precisely what the danger is to the credibility of the anti-smoking movement of anti-smoking groups that are making inaccurate, implausible, insufficiently documented, and even fallacious claims.

People may not know the difference - and it is going to be increasingly difficult to try to convince policy makers and the public that the movement is scientifically trustworthy, but just not with regards to Helena, Pueblo, the 20-minute heart attack claim, the 30-minute heart attack claim, etc.

I don't want to be in the position of having to say: "Well - if you set aside these 10 claims that we are making, we are most credible and trustworthy in what we're saying." Unfortunately, we're pretty much already there.

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About Me

Dr. Siegel is a Professor in the Department of Community Health Sciences, Boston University School of Public Health. He has 32 years of experience in the field of tobacco control. He previously spent two years working at the Office on Smoking and Health at CDC, where he conducted research on secondhand smoke and cigarette advertising. He has published nearly 70 papers related to tobacco. He testified in the landmark Engle lawsuit against the tobacco companies, which resulted in an unprecedented $145 billion verdict against the industry. He teaches social and behavioral sciences, mass communication and public health, and public health advocacy in the Masters of Public Health program.